Previous Topic

Next Topic

Targeted therapy for basal and squamous cell skin cancers

Doctors have found some of the gene changes that make skin cancer cells different from normal cells, and they have begun to develop drugs that attack these changes. These targeted drugs work differently from standard chemotherapy drugs. They may work sometimes when chemotherapy drugs don’t. They may also have less severe side effects. Doctors are still learning the best way to use these drugs to treat skin cancers.

An example of a targeted drug is vismodegib (Erivedge®), which can be used to treat some advanced or recurrent basal cell skin cancers. It is very rare for basal cell cancers to reach an advanced stage, but when they do, these cancers can be hard to treat. Most basal cell cancers have mutations (changes) in genes that are part of a cell signaling pathway called hedgehog. The hedgehog pathway is crucial for the development of the embryo and fetus and is important in some adult cells, but it can be overactive in basal cell cancers. Vismodegib targets a protein in this pathway.

Vismodegib is a pill, taken once a day. In people with basal cell cancers that have spread or come back after surgery and other local treatments, it has been shown to help shrink tumors in about a third of patients, although it’s not yet clear if it helps people live longer.

Side effects can include muscle spasms, joint pain, hair loss, fatigue, problems with taste, poor appetite and weight loss, nausea and vomiting, diarrhea, and constipation. Vismodegib can also cause women to stop having their periods for a time.

Because the hedgehog pathway affects fetal development, this drug should not be taken by women who are pregnant or could become pregnant. It is not known if it could harm the fetus if it is taken by a male partner. Anyone on this drug should use reliable birth control during and for some time after treatment.